News | April 15, 2009

SCCT Urges Physicians to Use Appropriate Modalities for MPI

April 15, 2009 - The results of the Detection of Ischemia in Asymptomatic Diabetes (DIAD) study, released in today’s Journal of the American Medical Association (JAMA), found that myocardial perfusion imaging (MPI) screening for coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes did not result in a significant reduction in the rate of heart attacks and death compared to patients who were not screened.

In the DIAD trial, which included 1,123 participants with type 2 diabetes and no symptoms of CAD, patients were randomly assigned to be screened (n=561) for CAD using MPI, or not to be screened (n=562). The average follow-up was 4.8 years, and researchers found that when analyzed according to randomization, there were 15 events in the screening group vs. 17 events in the no-screening group. Of those in the screened group, 409 participants with normal results and 50 with small MPI defects had lower cardiac event rates than the 33 with moderate or large MPI defects. Coronary angiography was performed within 120 days after screening in 4.4% of the screened group. By comparison, only three of the patients in the no-screening group underwent angiography within 120 days after randomization. As the authors note, these figures do not support MPI as being a good screening test for asymptomatic CAD in diabetic patients.

“The problem with screening diabetics with MPI is that this test detects coronary arteries with enough plaque in the arteries that blood flow is restricted. A large proportion of diabetic patients don’t have any plaque buildup in their arteries,” said cardiac imager, Daniel S. Berman, M.D., SCCT president and chief of cardiac imaging and nuclear cardiology at Cedars-Sinai Medical Center. “The use of coronary calcium scanning, a less expensive procedure that can detect the earliest stages of disease, offers a tool to select the patients who might benefit from the MPI procedure.”

CAD is the leading cause of death in individuals with type 2 diabetes. MPI can be an excellent diagnostic tool in symptomatic patients, but is not appropriate for assessing the plaque burden, which would be the most likely cause of myocardial infarction in the asymptomatic patient. Coronary calcium scoring clearly and accurately identifies the risk in an asymptomatic patient, as reported by Detrano et al in “Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups,” published in The New England Journal of Medicine, March 27, 2008. Detrano et al found that “The coronary calcium score is a strong predictor of incident coronary heart disease and provides predictive information beyond that provided by standard risk factors.” (New England Journal of Medicine, 2008; 358:1,336-1,345.)

For more information: www.SCCT.org

Related Content

CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta. Image courtesy of Christopher Maroules, M.D.

News | Computed Tomography (CT)| January 12, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Siemens Healthineers Strengthens CT Portfolio With Four New Systems at RSNA 2017

The Somatom Force with the new FAST 3D Camera

Technology | Computed Tomography (CT)| December 14, 2017
December 14, 2017 — Siemens Healthineers introduced four new...
Toshiba Medical Introduces Aquilion Prime SP CT System at RSNA 2017
Technology | Computed Tomography (CT)| December 13, 2017
December 13, 2017 — Toshiba Medical, a Canon Group company, introduced its new Aquilion Prime SP...
Philips Debuts IQon Elite Spectral CT Scanner at RSNA 2017
Technology | Computed Tomography (CT)| December 11, 2017
At the 2017 Radiological Society of North America (RSNA) Annual Meeting, Philips unveiled the IQon Elite Spectral CT,...
Toshiba Highlights Ultra-High Resolution CT at RSNA 2017
News | Computed Tomography (CT)| December 06, 2017
Toshiba Medical, a Canon Group company, showcased the Aquilion Precision, what it calls the world’s first ultra-high...
Samsung Unveils Mobile CT OmniTom at RSNA 2017
Technology | Computed Tomography (CT)| November 26, 2017
Samsung Electronics debuted its OmniTom mobile 16-slice computed tomography (CT) scanner at the Radiological Society of...
Siemens Healthineers Announces First U.S. Installs of Somatom go.Up CT System
News | Computed Tomography (CT)| November 15, 2017
November 15, 2017 — Center for Diagnostic Imaging (CDI), one of the nation’s largest providers of diagnostic imaging
Medis Releases QAngio CT v3.1
Technology | Computed Tomography (CT)| October 09, 2017
Medis has released a new version of its QAngio CT (computed tomography), which can now be launched from the Medis Suite...
Hitachi Supria True64 CT Receives FDA Clearance
Technology | Computed Tomography (CT)| September 15, 2017
Hitachi Healthcare Americas Inc. announced it has attained U.S. Food and Drug Administration (FDA) 510(k) clearance to...
Orange County, Calif. Hospital Adopts Siemens Somatom Force CT for Cardiac Imaging
News | Computed Tomography (CT)| September 12, 2017
Hoag Memorial Hospital Presbyterian recently became the first hospital in Orange County, Calif., to install the Siemens...
Overlay Init